Policy Updates: Hill Happenings and Administration Activities

By Mike Weir October 26, 2020

Hill Happenings

COVID-19 Relief Updates

Congressional and Administration leaders remain in a deadlock over another round of COVID-19 stimulus. The House released and passed an updated version of the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES) Act, which proposes an additional $100 million for the Ryan White HIV/AIDS Program and $65 million for the Housing Opportunities for Persons with AIDS (HOPWA) Program. The package is unlikely to be taken up by the Senate. NASTAD will continue to monitor the appropriations process and stimulus negations and advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

House Members Circulate Letter on 340B

Six House members are asking their colleagues to sign onto a letter to Health and Human Services (HHS) Secretary Alex Azar overs concerns about changes being made to reconfigure the 340B drug pricing program “from one of up-front discounts to post-sale rebates.” The letter states that “such a change would greatly harm Community Health Centers’, Ryan White HIV/AIDS clinics’, safety-net hospitals’, and other covered entities’ access to 340B savings. It also threatens to cause manufacturers to be in violation of their statutory responsibility to provide 340B pricing, creating significant compliance issues.”

Administrative Activity

Ending the Epidemic Stakeholder Webinar

On Thursday, October 29, 2020, the Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) will host a stakeholder webinar on efforts to implement the Ending the HIV Epidemic: A Plan for America (EHE) initiative. The EHE Stakeholder webinar will be held from 2:00-3:30 PM ET. Click here to register.  

PACHA Virtual Meeting

The Presidential Advisory Council on HIV/AIDS (PACHA) will hold its 69th full Council meeting virtually on Wednesday, December 2 and Thursday, December 3, 2020 from 1:00 - 5:00 PM (ET). The meeting agenda will be posted on the PACHA page on HIV.gov prior to the meeting. Instructions on attending this meeting virtually will be posted one week prior to the meeting here.

CDC YRBS Data Summary & Trends Report Released

“CDC released the, Youth Risk Behavior Surveillance Data Summary & Trends Report: 2009-2019, which provides an in-depth look at trends in sexual behaviorhigh-risk substance use, experience of violence, mental health, and suicide. Risk behaviors co-occur, and many students experience multiple risks across these four priority areas that are closely linked to HIV and STD risk.

This 2020 report examines 24 variables and includes three new health behaviors—recent prescription opioid misuse, STD testing, and HIV testing. It also provides data on the health behaviors and experiences of sexual minority youth from the 2015, 2017, and 2019 cycles of the national Youth Risk Behavior Survey (YRBS), allowing trends to be reported for this population for the first time.”    

National Latinx AIDS Awareness Day

October 15 was National Latinx AIDS Awareness Day (NLAAD). The Centers for Disease Control and Prevention (CDC) provided free tools in the NLAAD Resource Center to help in supporting your awareness activities and testing events. 

AHEAD Dashboard Updated to Reflect 2020 Data on Two Key Indicators

America’s HIV Epidemic Analysis Dashboard (AHEAD), an online HIV data visualization tool, has been recently updated. AHEAD offers graphical representations of data on the six EHE HIV indicators for the 57 jurisdictions prioritized in the federal initiative, as well as state data for the 21 states in which EHE counties are located. The recent AHEAD update incorporates the preliminary cumulative quarterly 2020 HIV data from the CDC on two key EHE indicators. Data for the years 2019 and 2020 are preliminary.  Due to the impact of COVID-19, please interpret with caution.

New FAQs for PS22-2103

The CDC’s Division of Viral Hepatitis (DVH) completed an additional update to the Frequently Asked Questions (FAQ) section of the webpage for funding opportunity PS21-2103 Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments.

The updated FAQs include responses to questions posed on the October 14 informational webinar for PS21-2103 and include updates to the evaluation and work plan template based on feedback from prospective applicants. NASTAD notified viral hepatitis prevention and surveillance coordinators immediately upon receiving notification of the updates from DVH. This new content can be found via the PS21-2103 FAQ webpage.

Fiscal Year 2021-2025 NIH Strategic Plan for HIV and HIV-Related Research

“The National Institutes of Health (NIH) Office of AIDS Research (OAR) released two key documents to guide the NIH HIV research program for years to come: (1) The FY 2021–2025 NIH Strategic Plan for HIV and HIV-Related Research (the Plan), and (2) the FY 2021–2025 Notice (NOT-OD-20-018), which present NIH HIV/AIDS Research Priorities and Guidelines for Determining HIV Funding. The FY 2021–2025 Plan serves as the guiding framework for OAR to allocate funds to the NIH Institutes, Centers, and Offices that advance the NIH-wide HIV research agenda and ensure investment of resources in the highest priority areas.” 

Resources

“On the Air” with ANEA

“Each month ANEA brings you one Ending the Epidemic topic discussed from two perspectives— community and government. Join ANEA for a live monthly, hour-long, and interactive conversation between hosts ANEA Coordinator, Edric Figueroa, and Crystal Townsend, END HIV Houston Coordinator, and special guests.”

Episode 1: Any way the Dust SettlesEnding the Epidemic and the 2020 Presidential Election

October 28th at 1 PM EST

“What’s at stake with the upcoming election as it relates to HIV? Last month ANEA sat down with staffers from the Biden campaign to detail our desires for any president going into 2021. (ANEA requested a meeting with the incumbent president’s team to no avail.) Hear about that conversation and how COVID-19, the Black Lives Matter uprisings, and the recent uptake in violence against migrants is changing the political dialogue and response to HIV. And more!” Register here for the inaugural episode of "On the Air" with ANEA.  

O’Neill Institute Releases New COVID-19 Briefs

In October 2020, the O’Neill Institute released two briefs. The first brief, Big Ideas: Integrating Telehealth into HIV Services Systems Can Help to Sustain Improved Outcomes, discusses how the COVID-19 pandemic has spurred greater adoption of telehealth services and identifies key policy actions that are needed for HIV telehealth services delivery to evolve from a crisis response to an integrated component of sustainable, high-quality care delivery. 

The second brief, Big Ideas: Supporting HIV Programs Through COVID-19 and Beyond Is Critical to Improving Health Equity, discusses how the COVID-19 pandemic has exposed inequities in the United States and weaknesses in the public health response at the federal, state, and local levels. The brief outlines policy recommendations for fighting COVID-19, improving equity, and sustaining momentum in responding to HIV

On All Sides: How Race, Ethnicity & Gender Influence Health Risk for Transgender Students of Color

“Available literature details the profound health disparities students of color endure due to social, economic, environmental, and structural disparities. Some literature describes health disparities between transgender and cisgender students due to similar reasons. Yet, limited population-based data focuses exclusively on the health risk behavior and outcomes of transgender students of color. The findings and recommendations offered in this report will assist educators, policymakers, researchers, and advocates design meaningful interventions that can reduce health risk behaviors and improve health outcomes for transgender students of color.”

Preventing HIV in DeKalb County, Georgia: One Conversation at a Time

To jumpstart national efforts to end the HIV epidemic, Georgia’s DeKalb County is connecting more people to vital HIV prevention options and empowering them to lead longer, healthier lives. They are doing this by:

MMWR: Barriers to Antiretroviral Therapy Adherence Among HIV-Positive Hispanic and Latino Men Who Have Sex with Men —United States, 2015–2019

Webinar: Copay Accumulators and Other Barriers to Affordable Healthcare

Date & Time: Thursday, October 29 from 12:00 – 1:00 PM ET

“We look forward to seeing everyone again on October 29th from 12-1pm ET for our second webinar of the series. We will have wonderful speakers, talking about how we can advocate for our patients and the work that has been done in states to ban copay accumulators.” Please register here.

Ending the HIV Epidemic: Culturally Attuned Educational Materials for American Indians/Alaska Natives

“As one of several Indian Health Service activities supported by the Minority HIV/AIDS Fund (MHAF) in Fiscal Year 2020, the Urban Indian Health Institute (UIHI) is currently leading a project focused on creating  culturally attuned HIV education materials—including print, digital, and video formats—for both American Indian and Alaska Native patients and the healthcare providers who serve them.

Among the new materials being developed under this project, in March 2020, UIHI released a short film, Positively Native , in which long-time HIV survivors Bill Hall (Tlingit), Shana Cozad (Kiowa), and Hamen Ides (Lummi) discuss their lived experiences with HIV stigma, discrimination, and advocacy. Along with the film, UIHI released an accompanying toolkit that includes a facilitator's guide, discussion questions, and a presentation on the basics of HIV. The organization presented Positively Native to an audience of 38 people at the International Indigenous Pre-Conference on HIV/AIDS in July 2020.”

Be a Voice for Local Public Health: Join NACCHO’s HIV, STI, & Viral Hepatitis Sentinel Network

“Join over 100 local health departments from more than 40 states participating in NACCHO’s HIV, STI, and Viral Hepatitis Sentinel Network (Sentinel Network). The Sentinel Network is an opportunity to shape national technical assistance and share your local public health perspective while engaging with colleagues nationwide. Members complete brief surveys on an approximately quarterly basis on their HIV, STI, and hepatitis programs, including their activities and services, partnerships, needs, challenges, and successes. Following each survey, Sentinel Network members are invited to discuss findings among their peers at NACCHO-hosted learning events. Sign up here or visit our website for more information. Contact Kat Kelley (kkelley@naccho.org) with any questions.”

Job Postings

Program Specialist II (Clinical) – Virginia

The Virginia Department of Health is hiring a Program Specialist II for the VA Medication Assistance Program. This position will serve as the program’s clinical liaison for the Virginia Medication Assistance Program (VA MAP) to the State Pharmaceutical Assistance Program, the VDH Division of Pharmacy Services, and to agencies serving justice-involved populations and other HIV-related medication assistance services. Will co-manage the ADAP formulary with the Assistant Director for Medication Access and serve as the technical and clinical liaison from the VA Ryan White Part B program to many different stakeholders. Establishes and monitors the effectiveness of Care Coordination (CC) services, which prioritizes services to people recently released from incarceration. Recruits, educates, and trains physicians, nurse practitioners, physician assistants, and other clinicians and stakeholders on emerging and existing HIV medications, treatment adherence, and treatment guidelines for HIV infection among various populations. This position closes on 10/28/2020. To apply for this position and see a more detailed job description, please go to http://jobs.virginia.gov/ and the position number is EP 178.

ADAP Retention Coordinators – Virginia

The VA Medication Assistance Program is hiring two Coordinators and one Lead Coordinator to conduct short term, extensive outreach to clients of Virginia’s Ryan White Medication Assistance Program for who do not response to traditional outreach methods for eligibility and recertification. These are field-based positions to help clients maintain their program eligibility and conduct mini-case management assessment to determine if the client needs referrals to case management for complex or acute needs that may be disrupting their access and adherence to treatment, including taking medications as prescribed. The Lead Coordinator position is a supervisory position for the two Retention Coordinators. These are contractual positions working a minimum of 40 hours per week, but do not offer benefits (annual leave, sick pay, or health insurance). The pay is up to $30 per hour based on experience.

These positions close on 11/6/2020. To apply, please send your resume to myras@tscti.com, rajeshwarj@tscti.com, or dgsjobs@tscti.com and put ADAP Retention Coordinators in the subject line. Applicants must successfully pass a background investigation.

Trauma Informed Care Coordinator – Virginia

The Division of Disease Prevention (DDP) at the Virginia Department of Health (VDH) is currently seeking a qualified applicant for a Trauma Informed Care (TIC) Coordinator. This position will lead the VDH’s DDP TIC Initiative, to carry out the strategies and activities of Virginia’s Integrated HIV Care and Prevention plan related to TIC and other related programming. Responsibilities will include identifying, coordinating trauma informed training needs of DDP and community partners and ensuring DDP programs implement trauma informed best practices. The TIC Coordinator will facilitate the Resilience Warriors Workgroup, which functions in an internal advisory capacity to DDP’s leadership team and as champions to ensure the incorporation of trauma informed principles into the Division’s work. This is a contractual position through Virginia’s Ryan White HIV/AIDS Part B Program. This position does not offer benefits; and the hourly pay rate is up to $35/hour based on experience. Salary information: This is a contractual position that does not have benefits.

This position closes 10/30/2020. To apply for this position, please send your resume and cover letter by email to myras@tscti.com, rajeshwarj@tscti.com, or dgsjobs@tscti.com and in the subject line put “Applying for Trauma Informed Care Coordinator with VDH”. Applicants must successfully pass a background investigation.

Virginia Medication Assistance Technicians Levels II and I – Virginia

The VA Medication Assistance Program (VA MAP) provides access to critical HIV-related treatment for low-income individuals who have no other resources to pay for their medications. The Medication Assistance Technician (MAT) Level I manage telephone, fax, and written communications with consumers, providers, vendors, insurance companies, HCS team members, and others. The MAT I conducts individual client’s VA MAP eligibility and recertification in accordance with the most current Health Resources and Services Administration (HRSA) guidance and program policies and supports all daily operational activities of the VA MAP including staffing the program’s telephone hotline. The MAT I also supports daily VA MAP operations including responding to and managing client inquiries that come through the Eligibility Hotline and provider communications through other channels, referring clients to resources, resolving medication access issues, assisting with insurance enrollment and contacting clients to obtain additional application information. Candidates must have very good customer service skills, strong computer skills, the ability to follow instruction, problem-solve medication access issues, and accurately collect, organize, analyze, manage, and report data. Minimum requirements are a high school diploma or equivalent training and experience. Knowledge of HIV/AIDS health care services delivery and call center experience preferred. These are contractual positions working a minimum of 40 hours per week, but do not offer benefits (annual leave, sick pay, or health insurance). For Level I, the pay ranges from $18-$22 per hour based on experience. The Medication Assistance Technician Level II demonstrates a mastery of all duties and skills for the Level I position, in addition to providing training for new Level Is and assists with tasks and projects as assigned by their supervisor. Level II pay ranges from $23-$26 per hour based on experience.

These positions are open until filled. To apply for either of these positions, please send your resume and cover letter by email to myras@tscti.com, rajeshwarj@tscti.com, and dgsjobs@tscti.com, and in the subject line put “VA Medication Assistance Technician Level I or VA Medication Assistance Technician Level II”. Applicants must successfully pass a background investigation.

STD Epidemiology and Surveillance Team Lead – Texas

The Texas Department of Health Services is seeking a STD Epidemiology and Surveillance Team Lead in the STD/Hepatitis C Epidemiology and Surveillance Group of the HIV/STD/HCV Epidemiology and Disease Surveillance Branch. Under the supervision of the group manager the Epidemiologist III performs highly advanced senior-level research and epidemiological work requiring specialized knowledge of STD surveillance. Designs and conducts advanced epidemiological research, evaluating populations and their risk factors for STDs using data from the STD reporting systems and other large data sets in the Epidemiology and Surveillance Branch. Prepares and presents research findings on STD issues in reports, professional journals, national conferences, and state meetings. Plan, assign, and/or supervise the work of others. Works under minimum supervision with extensive latitude for the use of initiative and independent judgment.  

Program Specialist IV — Texas

The Texas Department of State Health Services is seeking a Program Specialist for the HIV/STD Prevention & Care Branch. The Program Specialist IV (PS IV) is responsible for ensuring that organizations that enter into written agreements with the Department of State Health Services (DSHS) to provide HIV, STD, and HCV programs, deliver services that are consistent with the needs of the population to be served and are in accordance with State and Federal mandates and program requirements. The PS IV ensures compliance with these requirements through advanced consultative services, formal site reviews, technical assistance visits, and desktop reviews. Administers and oversees HIV/STD/HCV prevention activities, which may include HIV testing strategies, linkage to HIV-related medical care, structural interventions, nPEP/PrEP, and varied evidence-based interventions. Plans and directs the development, implementation, and evaluation of HIV/STD/HCV programs. Collaborates closely with other colleagues within the DSHS and HHSC to develop and compose programmatic guidelines and standards, and policies and procedures, which are distributed internally and externally. Works under the direction of the HIV Prevention Manager with latitude for use of initiative and independent judgment. This position closes on October 28, 2020.

Ending the HIV Epidemic Treatment Coordinator – Tarrant County, TX

The Ending the HIV Epidemic Treatment Coordinator oversees implementation of the Ending the HIV Epidemic grant activities for the Tarrant County HIV Administrative Agency. This position focuses on operational functions while working with community partners and sub-recipients to drive changes impacting the lives of more than 6,000 clients living with HIV. The Coordinator will assist with preparing the grant application, developing the workplan, overseeing grant-related reporting, monitoring the budget, and supervising Ending the HIV Epidemic staff. The posting may close at any time.

HIV Planner - HIV/STD DSHS Grant – UT Austin

The HIV Planner, in coordination with the UT-Austin Health Innovation and Evaluation Team and the Texas Department of State Health Services (DSHS) HIV Care Services Group and the HIV/STD Prevention and Care Branch Planning team, will perform comprehensive, advisory duties in developing, planning, and monitoring the development and implementation of HIV strategic, operational, program, and technical assistance plans.

HIV Prevention Manager — Ohio

The Ohio Department of Health’s Bureau of Infectious Diseases is seeking one candidate to fill their Health Planning Administrator 2 role for the HIV Prevention program. The Manager would be responsible for coordinating all components of the HIV Prevention Program (e.g., managing the statewide HIV testing program, implementing high-impact prevention strategies including pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and blood-borne pathogen prevention programs, managing the statewide PrEP assistance program known as PAPI (Prevention Assistance Program Interventions), collaborating with the STI Prevention program to achieve partner services and linkage to care performance measures, implementing innovative HIV testing initiatives, managing the deliverables of contractors, reducing health disparities among disproportionately impacted populations, providing leadership in the statewide community planning group and community-level interventions, demonstrating the application of feedback from stakeholders in community planning documents and activities consistent with federal guidance, provide programmatic leadership in cluster investigation and outbreak response related to HIV transmission).

Program Director (Public Health) – Washington, DC

NGA is looking to add a bright, resourceful, and organized Program Director to our Center for Best Practices team. This position reports to the Director or Deputy Director. The Program Director’s primary responsibilities will be to manage the public health portfolio, including supporting governors in their efforts to lead the public health response to the COVID-19 pandemic. Key issue areas will include preparing for and responding to public health emergencies, strengthening state public health capacity and partnerships, improving COVID-19 testing and contact tracing, addressing the spread of infectious diseases, advancing chronic disease prevention efforts, and supporting health equity and reducing health disparities for at-risk populations, among other population and public health issues. This position is open until filled.

Open Positions – New York State

The New York State Department of Health, in partnership with Health Research, Inc, has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.

ManagerWashington, DC

NASTAD is seeking a Manager for the Policy & Legislative Affairs Team. The Manager, Policy & Legislative Affairs plays a vital role in managing the development and implementation of hepatitis-related federal appropriations strategies, including for the NASTAD convened Hepatitis Appropriations Partnership, and legislation related to hepatitis prevention, care and treatment issues.  This position manages the day-to-day activities necessary to implement hepatitis-related federal legislative and regulatory goals.  The Manager also interfaces with governmental agencies, national organizations, coalitions and other non-governmental organizations to promote NASTAD’s legislative and policy agenda.  In addition, this position interfaces with NASTAD members to develop their understanding of the federal policy process and respond to their inquiries.  Demonstrated ability to execute projects in a timely manner is also required. 

News Bulletin

Trump Considers Cutting HIV and COVID-19 Funds in Liberal Cities

“The Trump administration is looking into slashing federal funds to over 200 health programs in Democrat-led cities President Trump has labeled “anarchist jurisdictions,” reports Politico based on documents it obtained. A group of prominent AIDS organizations issued a joint statement in response to the possible funding cuts: “Any effort by the Trump administration to slash coronavirus relief funds or lifesaving HIV treatment, under the misguided guise of scoring political points, would be deeply harmful and even illegal under current appropriations laws. The programs identified by the White House are critical components in our ongoing efforts to end the HIV epidemic and global pandemic, and curtailing these lifesaving services would put this administration’s own goal of reducing new HIV transmissions by 90% by 2030 at risk. Jeopardizing the health of underserved and at-risk communities is a clear abdication of presidential responsibilities, and we vehemently oppose any such actions.” The statement’s signatories include AIDS United, NASTAD (formerly the National Alliance of State and Territorial AIDS Directors), the National Coalition of STD Directors, NMAC (formerly the National Minority AIDS Coalition) and The AIDS Institute.”

Scaling up HIV Prevention Services in STD Specialty Clinics

“Today, data show that STD clinics serve a high volume of racial/ethnic minorities, gay and bisexual men, and transgender people, and that they have become a primary source of both STD and HIV prevention services for people without regular access to healthcare. As a result, STD clinics will play a vital role in the nation’s ambitious federal initiative Ending the HIV Epidemic: A Plan for America (EHE). However, these clinics are vastly under-resourced. An FY2020 investment from the HHS Minority HIV/AIDS Fund (MHAF) aims to address that by bolstering training and technical assistance (T/TA) efforts so STD specialty clinics can better provide HIV prevention services.”

Nimble, Collaborative, Community-Driven: Lessons from Hep Free 2030, Hawai'i's New Hepatitis Elimination Strategy

“Hawai'i has one of the highest rates of liver cancer in the United States. Hepatitis B and hepatitis C are the leading causes of liver cancer in the state and could affect up to 63,000 people across the islands. Most adults at-risk for and living with chronic hepatitis B or chronic hepatitis C do not know it and therefore do not access hepatitis screening, vaccinations and/or treatment. To address this health crisis, Hep Free Hawai'i (HFH) released the state’s first hepatitis elimination plan on July 28, 2020 to coincide with World Hepatitis day.”

Opioid Crisis Also Affects HAV and HBV Rates

“For the last 15 years, hepatitis A virus (HAV) had been associated mostly with international travel to countries where the virus is endemic, and with contaminated food, but current U.S. outbreaks of HAV are now primarily spread by person-to-person contact.”

Among Older Men, HIV Is Linked to Higher Dementia Risk

“HIV is associated with an increased risk for dementia among older men, aidsmap reports. Kirsten Bobrow, DPhil, of the University of California, San Francisco, and her colleagues analyzed data on 2,228 veterans from the U.S. Veterans Health Administration System, covering 2005 to 2015. They published their findings in the journal AIDS. The study included data on 1,114 veterans living with HIV, all of whom were 55 or older. They were matched with 1,114 HIV-negative vets according to age, sex, race and substance use (including tobacco use or unhealthy use of drugs or alcohol).”